A stage versus stage survival analysis of small bowel and colon adenocarcinomas using the SEER database.
Bibliographic record
Abstract
e16265 Background: Current recommendations for adjuvant chemotherapy for small bowel adenocarcinomas (SBAs) are largely based on extrapolation from colon cancer data. As a result, many stage I and stage II SBAs may not be offered adjuvant chemotherapy. This study evaluated the survival outcomes for SBAs utilizing colon adenocarcinoma as a benchmark for prognosis. Methods: Survival analysis comparing small bowel and colon adenocarcinomas was carried out using the SEER database. Cases diagnosed between 2004 and 2014 with complete demographic and staging information were included in this analysis. Results: A total of 557 small bowel and 39272 colon cancer cases were included. Compared to colon primaries, SBAs were associated with younger age (p=<.01), male gender (p=<.01), black ethnicity (p=<.01), lower rate of stage I (p=<.01) and higher rate of stage III (p=<.01) presentation. Univariate analysis demonstrated that SBAs are associated with worse outcomes compared to colon primaries of the equivalent stage (Table). Additionally, the outcomes for stage I and II SBAs were more comparable to stage III colon cancer than their equivalent colon stage. When T3 and T4 stage II SBAs were compared separately to stage III colon cases, outcomes remained worse for T4’s (HR=1.58 p=<.01), while the outcomes for the T3 subset did not statistically differ (HR=0.98 p=0.89). When age, gender, race, grade, and stage were controlled for in multivariate analysis, SBA primaries remained associated with worse survival than colon primaries (HR=1.83 p=<.01). Conclusions: Stage for stage, survival outcomes for SBAs are worse than those arising from the colon. Additional research is needed to clarify the role of adjuvant systemic therapy for SBAs, including for patients with stage I and stage II disease that may not currently be considered for chemotherapy. Primary Site Stage Small Bowel I II III IV n 40 217 202 98 Survival* (months) 46.3 61.7 46.9 22.4 Hazard Ratio of Death vs. Colon Primary p Colon I 6619 99.4 2.34 <.01 2.49 <.01 3.97 <.01 8.73 <.01 II 14110 89.9 1.59 0.09 1.69 <.01 2.70 <.01 5.68 <.01 III 12047 76.0 1.16 0.58 1.24 0.04 1.85 <.01 3.83 <.01 IV 6496 30.4 0.34 <.01 0.37 <.01 0.59 <0.01 1.24 0.06 *Median Overall Survival
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".